Provider Demographics
NPI:1467850834
Name:COLORADO MEDICAL LEGAL CONSULTING, LLC
Entity Type:Organization
Organization Name:COLORADO MEDICAL LEGAL CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STRATTON
Authorized Official - Last Name:LEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-389-7832
Mailing Address - Street 1:14742 E LAKE PL
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80016-4712
Mailing Address - Country:US
Mailing Address - Phone:307-389-7832
Mailing Address - Fax:303-568-9077
Practice Address - Street 1:9395 CROWN CREST BLVD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8573
Practice Address - Country:US
Practice Address - Phone:303-269-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27885208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty